News Release

Worksite program to stop smoking among blue-collar workers yields notable success

Peer-Reviewed Publication

Dana-Farber Cancer Institute

BOSTON –– Blue-collar workers are more likely to quit smoking when workplace smoking cessation programs are combined with other occupational health and safety messages rather than when singled out, according to a study headed by Dana-Farber Cancer Institute researchers. The findings may lead to a new approach to improving working-class people's health.

The program, which was tested among workers at 15 manufacturing firms in Eastern Massachusetts, differed from previous smoking-cessation efforts in that it ran in tandem with a broader occupational health and safety initiative. The combination may have made the critical difference in the program's effectiveness, researchers say.

A report on the study and its impact on workers at the participating companies is being published in the August issue of the journal Cancer Causes and Control. It is currently available on its website.

"Despite an overall drop since the 1960s in the number of people who smoke, the rate of decline hasn't been equal for all groups," says the study's lead author, Glorian Sorensen, PhD, MPH, who is the director of Dana-Farber's Center for Community-Based Research. In 1997, the smoking prevalence among blue-collar workers was 37 percent for men and 33 percent for women, compared to 21 percent for men and 20 percent for women in white-collar occupations. Similar figures exist for other healthy habits such as eating sufficient fruits and vegetables (which can reduce the risk of certain kinds of cancers).

"There's evidence that although blue-collar workers attempt to quit smoking as often as other workers do, they tend to be less successful," Sorensen says. "Also, when messages about quitting smoking and eating healthily are presented in the workplace, they often don't have as big an impact on the habits of blue-collar workers as on others."

Such programs might be more effective, researchers theorized, if they were incorporated into ongoing efforts to reduce workers' exposure to health and safety hazards on the job. To test the idea, Sorensen and her colleagues randomly split the 15 participating companies into two groups. In one group, health-promotion activities such as smoking cessation and healthy eating would be offered on a stand-alone basis. In the other group, such activities would be integrated into occupational health and safety efforts.

At the end of two years, the investigators found that more than two times as many workers quit smoking in the second group of companies (those that used an integrated smoking-cessation message) than did their counterparts in the first group. This cessation rate was essentially the same as that of white-collar workers. In the area of fruit and vegetable consumption, however, no significant differences were found among the different groups.

"To our knowledge, this is the first smoking-cessation program that has produced markedly high rates of quitting smoking among blue-collar workers when tested in the workplace," says Sorensen, who also a professor of health and social behavior at Harvard School of Public Health. "It offers real encouragement that similar programs could be effective on a broad scale."

Investigators point to several possible reasons why the combined approach succeeded. One is that blue-collar workers may see job-related hazards as a greater threat to their health than smoking or bad nutrition. As a result, tying stop-smoking and healthy-eating programs into occupational safety efforts may help motivate workers to take action on both fronts.

In addition, the combined approach "conveys a sense that company management shares workers' concerns about their health and is willing to do its part to help workers lead healthier lives," Sorensen explains. "It addresses the broader priorities and concerns that workers have about their health."

As for the lack of increase in consumption of fruits and vegetables, researchers say a stronger case apparently needs to be made to workers about the benefits of good nutrition. They speculate that the connection between diet and occupational health may be weaker in workers' minds than that for smoking. More study of the issue is needed, they say, but suggest the need for programs that educate workers about how good nutrition can help them be fit for work, especially physical labor.

Collaborating with Sorensen on the study were researchers at Dana-Farber, the Harvard School of Public Health, the University of Massachusetts, and Monash Medical School in Victoria, Australia.

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The study was funded by the National Cancer Institute and with support from the Liberty Mutual Insurance Group. Dana-Farber Cancer Institute (www.dana-farber.org) is a principal teaching affiliate of the Harvard Medical School and is among the leading cancer research and care centers in the United States. It is a founding member of the Dana-Farber/Harvard Cancer Center (DF/HCC), designated a comprehensive cancer center by the National Cancer Institute.


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